Discovery of Phosphatidic Acid, Phosphatidylcholine, and Phosphatidylserine as Biomarkers for Early Diagnosis of Endometriosis

Jingjie Li, Yue Gao, Lihuan Guan, Huizhen Zhang, Jiahong Sun, Xiao Gong, Dongshun Li, Pan Chen, Zheng Ma, Xiaoyan Liang, Min Huang, Huichang Bi
Frontiers in physiology · 2018 · vol. 9 , pp. 14 · doi:10.3389/fphys.2018.00014 · PMID:29410629 · PMC5787104 · W2788808573
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⚙ AI-generated summary by claude@2026-06, 2026-06-08 ⓘ

This study identified phosphatidic acid, phosphatidylcholine, and phosphatidylserine as biomarkers in eutopic endometrium that distinguish early-stage endometriosis from controls.

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⚙ AI-generated deep summary by claude@2026-06, 2026-06-08 ⓘ

This cross-sectional study investigated lipid metabolite profiles in eutopic endometrium from 21 laparoscopically confirmed early-stage (stage I–II) endometriosis patients and 20 infertile control women, using UHPLC-ESI-HRMS-based lipidomics and multivariable logistic regression with ROC analysis. Compared with controls, endometriosis patients showed decreased phosphatidylcholine species (PC 18:1/22:6, PC 20:1/14:1, PC 20:3/20:4) and decreased phosphatidylserine PS 20:3/23:1, along with an increased phosphatidic acid PA 25:5/22:6; a 5-lipid biomarker strategy yielded sensitivity 90.5% and specificity 75.0% (AUC 0.871) for early-stage disease. The key limitation is that the analysis is based on a small single-center sample without a reported independent external validation cohort, and only eutopic endometrium was examined. This paper is centrally about endometriosis — it identifies early-stage endometriosis lipid biomarkers in eutopic endometrium (phosphatidic acid, phosphatidylcholine, and phosphatidylserine).

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Abstract

The sensitivity and specificity of clinical diagnostic indicators and non-invasive diagnostic methods for endometriosis at early stage is not optimal. Previous studies demonstrated that abnormal lipid metabolism was involved in the pathological development of endometriosis. Our cross-sectional study included 21 patients with laparoscopically confirmed endometriosis at stage I-II and 20 infertile women who underwent diagnostic laparoscopy combined with hysteroscopy from January 2014 to January 2015. Eutopic endometrium was collected by pipelle endometrial biopsy. Lipid metabolites were quantified by ultra-high performance liquid chromatography coupled with electrospray ionization high-resolution mass spectrometry (UHPLC-ESI-HRMS). Lipid profiles of endometriosis patients at early stage (I-II) was characterized by a decreased concentration of phosphatidylcholine (18:1/22:6), (20:1/14:1), (20:3/20:4), and phosphatidylserine (20:3/23:1) and an increased concentration of phosphatidic acid (25:5/22:6) compared with control. The synthesized predicting strategy with 5 biomarkers has a specificity of 75.0% and a sensitivity of 90.5%. Lipid profile of eutopic endometrium in endometriosis was effectively characterized by UHPLC-ESI-HRMS-based metabolomics. Our study demonstrated the alteration of phosphatidic acid, phosphatidylcholine, phosphatidylserine metabolites in endometriosis and provided potential biomarkers for semi-invasive diagnose of endometriosis at early stage.

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endometriosis

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